慢性乙型肝炎病毒感染者专科医院和社区卫生服务中心双向转诊运行情况研究

发布时间：2018-03-24 11:39

本文选题：乙型肝炎　切入点：慢性　出处：《中国全科医学》2015年19期

【摘要】：目的了解慢性乙型肝炎病毒感染者专科医院和社区卫生服务中心双向转诊的运行情况。方法以"十一五"规划中建立的1 019例慢性乙型肝炎病毒感染者随访队列为基础,因队列存在部分病例缺失,于2013年1月—2014年1月在首都医科大学附属北京地坛医院选取符合本研究纳入及排除标准的门诊或住院慢性乙型肝炎病毒感染者68例,将队列完善至1 019例。根据患者参与双向转诊社区管理情况,将其分为未参与社区管理组(n=497)和参与社区管理组(n=522)。比较两组一般资料,分析患者不愿意参加双向转诊社区管理的原因,并总结双向转诊绿色通道运行情况。结果 (1)1 019例慢性乙型肝炎病毒感染者中有51.2%(522/1 019)愿意参加双向转诊社区管理,有48.8%(497/1 019)不愿意参加双向转诊社区管理,两组患者性别、平均年龄、疾病类型及脱落病例比较,差异无统计学意义(P0.05)。(2)患者不愿意参加双向转诊社区管理的原因分别为担心歧视、担心社区医生业务水平低、担心社区卫生服务中心药物种类不全、担心社区卫生服务中心检查不准确,所占比例分别为11.5%(57/497)、91.5%(455/497)、95.0%(472/497)、78.3%(389/497)。(3)2013年3—10月,朝阳区共有69例慢性乙型肝炎病毒感染者参与了双向转诊绿色通道;2013年1月—2014年1月,10家推广此模式的社区卫生服务中心共有103例慢性乙型肝炎病毒感染者参与了双向转诊绿色通道。结论双向转诊绿色通道可行性较高,运行较顺畅,担心社区卫生服务中心药物种类不全和担心社区医生业务水平低是患者不愿意参加双向转诊社区管理的主要原因。
[Abstract]:Objective to understand the operation of two-way referral in hospital and community health service center of chronic hepatitis B virus infection. Methods based on the follow-up cohort of 1019 patients with chronic hepatitis B virus infection established in the 11th Five-Year Plan, From January 2013 to January 2014, 68 patients with chronic hepatitis B virus infection were selected from Beijing The Temple of Earth Hospital affiliated to Capital Medical University from January 2013 to January 2014 because of some missing cases in the cohort. The cohort was improved to 1 019 cases. According to the patients' participation in bi-directional referral community management, they were divided into two groups: the non-participating community management group and the participating community management group. The general data of the two groups were compared. The reasons why patients are unwilling to participate in bi-directional referral community management were analyzed, and the operation of green channel in two-way referral was summarized. Results 51.2% of 1019 patients with chronic hepatitis B virus infection were willing to participate in two-way referral community management. There were 48.8% 497 / 1019) who were not willing to participate in bi-directional referral community management. The difference between the two groups in terms of sex, average age, disease type and cases of abscission was not statistically significant (P0.05 / 1019). The reasons for the reluctance of patients to participate in bi-directional referral community management were, respectively, fear of discrimination. Worried about the low level of community doctors, worried about the variety of drugs in the community health service centers, worried that the examination in the community health service centers was not accurate, the percentages were 11.557 / 497 / 91.5 / 495 / 497 / 95.0 / 4722 / 4977 / 78.3a / 497.3) from March to October 2013, A total of 69 patients with chronic hepatitis B virus infection in Chaoyang district participated in the two-way referral green channel, and 103 patients with chronic hepatitis B virus infection participated in 10 community health service centres promoting the model from January 2013 to January 2014. Conclusion Bidirectional referral green channel is more feasible. The main reasons for patients' reluctance to participate in bi-directional referral community management were running smoothly, worrying about incomplete drug types in community health service centers and the low professional level of community doctors.
【作者单位】：首都医科大学附属北京地坛医院综合科;
【基金】：国家科技部“十二五”科技重大专项(2012ZX10004904) 首都十大危险疾病科技成果推广项目(Z121100005512005)
【分类号】：R512.62

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